Pubdate: Wed, 11 May 2016
Source: Daily News, The (South Africa)
Copyright: 2016 Associated Press
Contact: http://www.iol.co.za/dailynews
Details: http://www.mapinc.org/media/2941
Author: David Klepper, Associated Press
SHOOT-UP ROOMS GET A SERIOUS LOOK
ACROSS the US, heroin users have died in alleys behind supermarkets,
on city pavements and in the bathrooms of fast-food joints because
no one was around to save them when they overdosed.
An alarming 47 000 American overdose deaths in 2014 60% from heroin
and related painkillers such as fentanyl has pushed elected leaders
from coast to coast to consider what was once unthinkable:
government-sanctioned sites where users can shoot up under the
supervision of a doctor or nurse who can administer an antidote if necessary.
"Things are getting out of control. We have to find things we can do
for people who are addicted now," said New York state Assemblywoman,
Linda Rosenthal, who is working on legislation to allow supervised
injection sites that would also include space for treatment services.
Critics of the war on drugs have long talked about the need for a new
approach to addiction, but the idea of allowing supervised injection
sites is now coming from state lawmakers in New York, Maryland and
California, along with city officials in Seattle, San Francisco and
Ithaca, New York, who note that syringe exchanges were once
controversial, but now operate in 33 states.
While such sites have operated for years in places such as Canada,
the Netherlands and Australia, they face significant legal and
political challenges in the US, including criticism that they are
tantamount to waving a white flag at an epidemic that should be
fought with prevention and treatment.
"It's a dangerous idea," said John Walters, drug tsar under president
George Bush. "It's advocated by people who seem to think that the way
we should help sick people is by keeping them sick, but comfortably sick."
Argue
But proponents argue such sites are not so radical outside the US,
pointing to examples where they offer not only a place to shoot up,
but also health care, counselling and even treatment beds. In many
cases, the users are there to shoot up heroin or dangerous opioids,
though some take painkillers in pill form.
At Sydney's Medically Supervised Injecting Centre, more than 5,900
people have overdosed since it opened in 2001. No one has died.
It's the same at Insite in Vancouver, British Columbia. About 20
overdoses happen there every week, but the facility has yet to record a death.
Sydney's facility is tucked between a hostel and a Chinese restaurant
in Kings Cross, the city's red-light district. Aside from the
security guard posted just inside the front door, it looks like a
typical health clinic.
At least two staffers, including a registered nurse, monitor the
injection room. They are not allowed to administer drugs, though
sterile needles are provided. If a patient overdoses, the nurse
delivers the antidote Narcan, which quickly reverses the overdose.
After users get their fix, they head to a second room with a
decidedly warmer feel. Coloured Christmas lights hang from the
ceiling; books and magazines line the shelves. Clients can relax with
a cup of coffee or tea or talk to staff. Some stay for 15 minutes;
others spend hours. They exit through a back door to protect their privacy.
The centre opened on an 18-month trial basis after a sharp increase
in heroin use in Sydney. The trial was repeatedly extended by
government officials until 2010, when it was granted permanent
status. A clinic in Amsterdam one of three injection sites in the
Dutch capital goes even further, distributing free heroin to
long-term addicts as part of a government programme created for
hardened addicts who might otherwise commit a crime to pay for their fix.
About 80 users visit up to three times a day. Most are men, and the
average age is 60. Many began using in the 1970s and 1980s.
"We would ideally like them to cut back their use," said Fleur
Clarijs, a doctor at the facility.
But, she said, the main objective of the facility is to reduce risk
to users and their effects on the community.
In Vancouver's seedy Downtown Eastside neighbourhood, Insite offers
patients treatment services just up the stairs from where they shoot
up. About a third of Insite's visitors request referral to a detox
programme, the clinic said.
A woman who gave her name as Rhea Jean was interviewed after recently
injecting herself there.
She felt nauseous and ran outside to vomit. Her face covered with
scabs, the long-time heroin user looks far older than her 33 years.
"It's a great place for active users in full-blown addiction. It
links you up to other programmes," said Jean, who hasn't sought
treatment through Insite.
A 65-year-old man who gave his name only as James because he's in a
12-step programme that requires anonymity said he had been using
heroin since age 22. He was clean for 17 years before relapsing; he
said he was sexually abused as a child and spent 23 years in prison.
He keeps returning to heroin, he said, because it provides release
from his problems. Insite is the one place he can go and be treated
if he reacts badly to the drug, he said.
"They saved my life three times," he said, adding that addiction
shouldn't be demonised.
"There's a large section of society that still refuses to accept it
as a disease," he said.
The three clinics we visited initially faced opposition from
politicians and members of the public but gradually won support, in
part because of studies showing reductions in overdose deaths and
open-air drug use in the surrounding community.
Found
A 2010 survey of residents and businesses in Kings Cross, for
instance, found strong support.
Insite was targeted for closure by Canadian Prime Minister Stephen
Harper and his Conservative Party. The case went to the Supreme Court
of Canada, which in 2011 told the government to issue an exemption to
the drug laws allowing Insite to operate.
"Insite saves lives," Chief Justice Beverley McLachlin wrote in the
decision. "Its benefits have been proven. There
Surveillance cameras, right, are mounted underneath a metal table
with chairs bolted to the floor where addicts can inhale heroin fumes
in a clinic in Amsterdam, Netherlands.
has been no discernible negative impact on the public safety and
health objectives of Canada during its eight years of operation."
Advocates in the US have long discussed the potential benefits of
injection sites but they point to the tripling of heroin and opioid
overdose deaths since 2000 as one reason why the suggestion is
starting to get serious consideration.
The deaths of actors Philip Seymour Hoffman and Heath Ledger put
celebrity faces on the risks of overdosing alone, and it was revealed
recently that representatives for Prince sought help for his
addiction to painkillers just a day before the musician was found dead. ANA-AP
- ---
MAP posted-by: Jay Bergstrom